CHAPTER 3: CLINICAL ASSESSMENT AND DIAGNOSIS Flashcards
It is a systematic approach to EVALUATE AND MEASURE psychological disorders
Clinical assessment
It is the process of determing disorder using the diagnostic criteria of DSM-5
Diagnosis
Two ways to assess psychological disorders
Clinical assessment
Diagnosis
What are the three basic concepts to determine the value of clinical assessment
Validity, reliability and standardization
It is degree of which the measurement is consistent
reliability
It is degree of which the measurement is design to measure
Validity
It is the application of certain standards to ensure CONSISTENCY accross different measurement
Standardization
What are the 6 strategies for clinical assessment?
Clinical interview, MSE, Semistructured Clinical Interview, Physical Examination, Behavioral assessment and Observational assessment
It is the CORE of most clinical work
Clinical interview
It is the systematic observation of behavior
MSE
It is two or more raters with the same results
Interrater reliability
It is two tests with the same result which the briefer one is selected
concurrent validity
It is what will happen to future
predictive validity
How many categories are there in MSE?
5 categories
A category which observed overt behavior, attire, appearance, posture and expressions
Appearance and behavior
A category which observed rate of speech, continuity of speech and content of speech
Thought process
A category which observed predominant feeling state if the individual, feeling state accompanying individual says
Mood and affect
A category which observed type of vocabulary, use of abstractions and metaphors
Intellectual functioning
A category which observed awareness of surroundings
“oriented times three”
Sensorium
It is the privileged communication
Confidentiality
It is the assessment which has the DIRECT observation to formally assess the patients
Behavioral assessment
It is assessment which is alternative to arrange the SIMILAR LIFE SITUATION used by the analyst
Analogue assessment
Assessment used to observe the ABC
Observational assessment
It is the overactive thyroid gland
hyperthyroidism
It is the underactive thyroid gland
hyporthyroidism
Withdrawal of cocain leads to ___
panic attacks
Hyperthyroidism leads to ____.
GAD
Hyporthyroidism leads to ____.
depression
Tumor leads to____.
Delusion/hallucination
Assessment that uses questions that are paraphrased to elicit useful information
Semistructured interview
ABC means
Antecedent, behavior, Consequences
It is happened before the behavior
Antecedent
It is happened after the behavior
Consequences
Operational definition
Identify the specific behaviors that are observable and measurable to know the treatment
Formal observation
Observer’s recollection and interpretaion of events
Informal observation
What are the two tests of psychological test?
Projective test and personality test (objective test)
It has ambigous stimuli
Projective test
It has straightforward answer
Personality test/inventory
Three examples of projective test
Sentence completion test, Rosrschach test and TAT
He established the Rorschach
Hermann Rorschach
They established the TAT
Christiana Morgan and Henry Murray
It has 30 cards, 31 pictures, 1 blank card
TAT
It has 10 inkblot pictures
Rorschach Inkblot
What are the purpose of TAT and rorschach?
Uncover the unconscious mind
Who are the analyst used the projective test?
Psychoanalyst
It tells dramatic story about the pictures
TAT
It has a straightforward description of the picture
Rorschach Inkblot
What is the example of Personality test or inventory?
MMPI
What is MMPI
MMPI stands for Minnoseta Multiphasic Personality Inventory
What is the disadvantage of MMPI to TAT and Rorschach?
Time and long test
It has 500 items of structured test
MMPI 1
This version of MMPI for adolescents
MMPI - A
It has 567 items of structured test
MMPI 2
What is the revised standardized Rorschach Inkblot test?
Comprehensive System by John Exner
What are the other versions of TAT?
Children Apperception Test (CAT)
Senior Apperception Test (SAT)
What are the revised standardized TAT?
Social Cognition Scale and Objection Relation Scale
A test that measures the ability to solve problem and used to know the school performance
Intelligence Testing
What are the two examples of Intelligence testing?
SBIS or SBIT and WAIS
SBIS was made by?
Alfred Binet and Theodore Simon
SBIT was made by?
Terman
Intelligence test measures the ___.
IQ
Formula of IQ Test
mental age / chronological age x 100
Who made the WAIS?
David Weschler
What are three version of WISC?
WISC III
WISC IV
WPPSI III
Weschler’s version for Adult
WAIS III
Weschler’s version for children
WISC IV
Weschler’s version for young children
WPPSI III
5 categories measured by IQ
Reasoning, verbal comprehension, attention, perception, memory
It is a test which to know the brain dysfunction
Neuropsychological test
What are the three neuropsychological tests?
bender visual motor gestalt test, Luria - Nebreska and Halsted Reitan neuropsychological tests
It is a battery test which administer pictures and lines that a child will copy. The more errors will mean the child has brain dysfunction
Bender Visual Motor Gestalt Test
Two battery tests to know the organic brain dysfunction
Luria - Nebreska and Halsted Reitan neuropsychological tests
It is to test the heart rhythmic beats
Rhythmic test
It is a test the grip of left and right hand
Strength of grip test
It is a test of learning and memory
Tactile performance test
There is a problem but no found difficulty
False positive
There is no problem but there is difficulty
False negative
It is a testing which to see the brain structure and brain functioning
Neuroimaging techniques
What are the two brain structure tests?
CT Scan and MRI
It used to locate abnormalities in the shape/structure of the brain
It has risk to the person due to radioactivity
CT Scan
A head of a person is placed in magnetic field through radio frequency signals.
It is more expensive.
MRI
It is the most sophisticated MRI that is used for onlu milliseconds
fMRI
It is the mosyt common fMRi technique to study the psychological disorders
Bold fMRI
What are the two brain functioning tests?
PET scan and SPECT scan
It is injected with traces attached to radioactive isotopes, or group of atoms.
It shows the precise active areas of the brain
PET scan
It is less accurate, less expensive but mostly used form than PET scan
SPECT scan
It is a test which assess the measurable changes in NS that reflects the emotional and psychological events
Psychophysiological assessment
It is used to measure the electrical activity in the brain
EEG
It is the calm and relaxed stage of sleeping waves.
The regular pattern of changes in voltage of the brain
Alpha waves
It is the most relaxed stage after 1 - 2 hours after sleep
More slower and irregular waves
Beta waves
Psychopysiological assessment is most useful for?
Sexual dysfunctions and disorder
headaches and hypertension
It is a technique used to monitor own’s behavior
Self-monitoring
What are the two kinds of self-monitoring?
Checklist and Behavior rating scale
It is a phenomenon which a person distort observational data duie to people’s observation
Reactivity
What are the two test for psychophysiological assessment?
EEG and ERP
It is known as evoked potential
It is hearing psychologically meaningful events
ERP (Evoked Related Events)
It measures the sweat gland of the PNS
GSR or Galvanic Skin Response
PET Scan can used for _____.
Alzheimer’s type dementia
It is a strategy which a problem is based on a uniquie individuals personality
Idiographic strategy
It is a strategy which it is a general class of problems
nomothetic strategy
It is the heart of science
Classification
The data has same attributes and relations
Classification
A classification based on scientific context
Taxonomy
A medical/psychological classification
Nosology
A label or name of disorder
Nomenclature
What are the three categorical/dimensional approaches?
Classical Categorical approach, Dimensional approach and Prototypical approach
This approach is based on biological perspective of emil kraeplin
Classical Categorical approach
Psychopathologsit believe it that it is the cause of disorder
A psychological and social factor integrates with biological factor causes disorder
It is an approach which quantify the disorder through scales
Dimensional approach
A combination of two approaches that characteristics are able to classify
Prototypical approach
DSM is a kind of what approach?
prototypical approach
It is the extent of disorder found in patient’s relatives
Familial aggression
Old name of Schizophrenia
Dementia praecox
Dementia means
deterioration of brain due to old age
Praecox means
premature
Old name of depression
Melancholia
Old name of bipolar depression
manic depressive disorder
He discover the schizophrenia
Emil kraeplin
He termed depression
Philippe Pinel
PRE WWII:
What happened during 1840?
U.S started the stimulus of nosology
PRE WWII:
What happened during 1880?
7 categories of mental health
Mania, melancholia, Dipsomania, Monomania, paresis, dementia and epilepsy
PRE WWII:
What happened during 1917?
America Medico of Psychological Association
gather mental health stat accross mental hospitals
PRE WWII:
What happened during 1921?
Changed to APA
develop nationally acceptable psychiatric clarification for diagnosing severe cases
POST WWII:
What happened during 1948?
ICD 6
10 categories psychoses and neuopsychoses
7 categories for disorders (behavior, personality and intelligence)
POST WWII:
What happened during 1952?
DSM I
“reactions” Adolf meyer for psychobiological view
POST WWII:
What happened during 1953-1967?
Erwin Strengel conductcomprehensive review about alck of mental-disorder listing on ICD 6 and ICD 7
POST WWII:
What happened during 1968?
DSM II
ICD 8
Eliminates “reactions”
POST WWII:
What happened during 1978?
ICD 9
published: 1975
POST WWII:
What happened during 1980?
DSM III
published: 1974
POST WWII:
What happened during 1987?
DSM III-TR
POST WWII:
What happened during 1992?
ICD 10
POST WWII:
What happened during 1994?
DSM IV
aligned to ICD 10
POST WWII:
What happened during 2000?
DSM IV TR
POST WWII:
What happened during 2013?
DSM 5
Aligned ICD 11
What are the major changes in DSM III and DSM III - TR?
- Tools of clinicians
- Aligned to reliability and validity but not all
- Multiaxial system
How many axis are there in mutliaxial system?
5 axis
What are the 5 axis?
- Clinical disorders
- Personality and mental retardation disorders
- General Medication conditions
- Psychosocial and environmental problems
- Global assessement of Functioning (GAF)
What are the maor changes in DSM 5?
- Removed multiaxial system and replaced to 3 sections.
- Dimensional approach was extended
- Introduces cross-cutting axes for severity, intensity frequency or duration of disorder
Wha are the three sections of DSM 5?`
- About the manual usage
- The disorders
- Disorders needed for further research
What happened to the axis in the DSM 5?
Axis I to III - it is the description of the disorders
Axis IV and V - It is for clinicians can make notion
It is all symptoms are present but in a midl form
Subtreshold
It refers to values and practices derive from ethic groups
Culture
What are the two criticisms of DSM - 5 and ICD 11?
- It emphasises more on the reliability than validity
2. It should be updated based on the emerging scientific knowledge
It is categorizing people
Label
It is stereotyping negative beliefs of a person
Stigma
It is a min. no. of criteria to meet the disorder
Threshold
It describes the group of disorders that shares biological and psychological system or dimensions
Spectrum
It is the old name of PMDD
LLPDD or Late Luteal Phase Dysphoric Disorder
The cause of PMDD in DSM III - R
Endocrine disorder
PMDD is first included in what version of DSM 5? And what part?
DSM III - R
Appendix
LLPDD changed its name in what version of DSM?
DSM IV
PMDD is under of what category?
Mood disorder
Clinics, hospitals are examples of ___
Primary care settings